Article

Background Stroke patients with severe symptoms of hemispatial neglect (HN) are
known to experience a weaker recovery than those less affected from the outset.
Correct identification of HN is therefore important throughout the course of
rehabilitation. Objectives To explore: (i) the course of clinical symptoms in
stroke patients with moderate/severe HN from acute setting to home, (ii) changes
in sensitivity of diagnostic tasks over time, and (iii) agreement between the
researcher's and patients' HN assessments. Methods Out of 79 consecutive
patients, we included 23 patients with moderate/severe HN following right
hemisphere stroke. The Catherine Bergego Scale was used as a benchmark for HN and
to measure the congruence between the researcher's and patients' HN assessments.
Diagnostic tasks included star cancellation, line crossing, line bisection,
m-fluff test, figure copying, and clock drawing. Data were collected at t1:
sub-acute stroke (days: M +/- SD = 10.3 +/- 5.25), t2: during rehabilitation
(days: M +/- SD = 51 +/- 8), and t3: following discharge (days: M +/- SD = 141.5
+/- 47.3). Results (i) 20 out of 23 patients had HN at t3. Associated stroke
challenges included paralysis, sensory loss, visual deficits, and extinction.
(ii) Combining the star cancellation and figure copying yielded the highest
sensitivity at all time points, even in patients with mild HN at t3. (iii)
Patients' HN scores differed from the researcher's at t1. The difference was
insignificant at t3. Conclusions Joint consideration of stroke severity,
functional difficulties, and patients' insight into neglect provides new
knowledge to increase clinicians' recognition of HN. More extensive studies are
needed to validate bedside screening with star cancellation and figure copying.

Langue : ANGLAIS